Acid Reflux Disease (GERD): Symptoms, Causes, & More

What is Acid Reflux Disease?

Acid reflux is a common condition that occurs when the stomach acid flows back up the esophagus. Acid reflux disease occurs when a valve at the end of the esophagus doesn’t close well when food arrives at the stomach. The acid backwash flows back up through the esophagus into the throat and mouth, giving you a sour taste.

Acid reflux can happen to anyone, and having heartburn and acid reflux now and then is normal. However, if you experience acid reflux and heartburn more than twice a week, you may have developed a condition called gastroesophageal reflux disease (GERD).

The condition should be treated with antacids and medications to relieve symptoms. GERD is a common condition in Western countries, affecting 20 to 30% of the population.

What are the Symptoms of Acid Reflux?

The most common symptom of acid reflux is heartburn, usually after overeating or persistent GERD. Heartburn is an uncomfortable burning sensation in the esophagus, and it worsens when lying down. It lasts for minutes or hours after eating food. Acid reflux makes you develop a bitter taste at the back of your mouth, and it might make regurgitation of contents from the stomach into the mouth.

The other symptoms of acid reflux include:

• Feeling pain when swallowing
• Nausea
• Vomiting
• Dry, persistent cough
• Chest pain
• Difficulty when swallowing
• Dental erosion and bad breath
• A hoarse voice
• Disrupted sleep
• Feeling like you have food stuck in the throat
• Hiccups.

What Causes Acid Reflux Disease?

The body has a circular band of muscle at the end of the esophagus called the lower esophageal sphincter (LES). When the mechanism is working perfectly, it relaxes and opens when you swallow, then it tightens and closes afterward.

If the sphincter weakens or relaxes when it shouldn’t, the stomach content rises back up into the esophagus, causing acid reflux. The constant backwash of acid irritates the esophagus lining, causing inflammation.

The other common cause of acid reflux disease is hiatal hernia. This is a stomach abnormality that occurs when the upper part of the stomach moves above the diaphragm. A diaphragm is a muscle that separates the stomach from the chest. The diaphragm helps keep acid in the stomach. If the diaphragm is affected, acid can move up into the diaphragm, causing the symptoms of acid reflux disease.

The other possible causes of acid reflux disease include:

• Lying down too soon after meals, especially large meals
• Eating large meals frequently
• Certain foods, such as spicy, dairy, and fried foods
• Bad eating habits such as eating too fast
• Too much pressure on the abdomen, mostly experienced by pregnant women
• Taking ibuprofen, aspirin, blood pressure medications, muscle relaxers, and anti-depressants.

How is Acid Reflux Disease Diagnosed?

Acid reflux disease is simple to diagnose. However, acid reflux disease can be confused with other chest problems, such as chest wall pain, pneumonia, heart attack, and pulmonary embolus. By talking about your medical history and symptoms, your doctor will know whether you have acid reflux or not.

Your healthcare provider can suggest some diet changes and medications that can help control the symptoms. If the strategies don’t work well, you will get tested for GERD. The following tests can be done:

Barium swallow: This test can check for narrowing of the esophagus or ulcers. In this test, you swallow a solution so that your doctor can see structures on X-ray.

Esophageal pH monitoring: In the test, a monitor is inserted into the esophagus. It will help your doctor learn how acid is being regulated in the body for some days.

Esophageal manometry: A tube is passed through the nose into the esophagus to measure the strength of esophageal muscles. A small tube with sensors will be inserted into your nose. The sensors will measure the strength of the muscles, sphincter, and spasms.

Impedance monitoring: This measures the rate of fluid movement along the esophagus.

Biopsy test: In this test, your doctor will cut a small tissue to examine it in the lap under a microscope to check for GERD and other abnormalities.

Upper GI series: In this test, a liquid moves through the tract as an X-ray tech takes pictures. The X-ray pictures will show the upper GI tract and any problems related to GERD.

Are there Medications that Can Manage the Symptoms of Acid Reflux Disease?

A combination of good lifestyle changes and medications can help control the symptoms of acid reflux disease. There are many over-the-counter medications and prescriptions that can relieve GERD. Most used medications are:

• Use of antacids that help neutralize stomach acid
• Foaming agents that coat the stomach to prevent reflux
• Prokinetics that empty the stomach faster, strengthen the LES, and reduce acid reflux
• Proton pump inhibitors that reduce the amount of acid the stomach makes
• H2 blockers that reduce acid production
• Baclofen prescription that reduce the relaxation of lower esophageal sphincter LES, which allows acid backwash.

These medications are effective and safe. However, they don’t work well for all people with acid reflux and they have side effects. For example, they can make it hard for the body to absorb nutrients, leading to malnutrition.

What are the Risk Factors?

Acid reflux disease affects people of all ages for different reasons, where some are unknown. While there is no main cause of acid reflux, there are certain health conditions and lifestyle choices that can lead to the disease. Some causes can be prevented, while others cannot. For instance, hiatal hernia is not preventable.

The factors that put you at high risk of acid reflux disease include:

• Being obese or overweight
• Smoking (active or passive)
• Chewing your food too fast
• Having a connective tissue disorder
• Being pregnant
• Snaking close to bedtime
• Constantly lying down or sleeping shortly after eating
• Certain beverages like coffee, soda, or alcohol
• Frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen
• Eating deep-fried foods, tomato products, citrus fruits, garlic and onions, fatty foods, and acidic foods

You have to keenly keep a record of the foods that trigger heartburn or acid reflux. A dietician will give you suggestions about the foods you should highly avoid and the ones you can take.

Are there Foods that Trigger Acid Reflux Symptoms?

Individuals who have been diagnosed with GERD find that some beverages and foods trigger their symptoms. Some triggers can be personal, while some are more triggering than others. Here are the foods that trigger acid reflux disease:

• Tomatoes and tomato sauce
• Fried foods
• Spicy foods
• High-fat foods
• Citrus fruits and juices
• Onions and garlic
• Soda
• Coffee
• Mint
• Chocolate
• Carbonated drinks.

Acid Reflux Disease in Infants?

Sometimes it is normal for a baby to spit up food and vomit. However, if the baby is vomiting or spitting frequently, they may have acid reflux disease. The potential symptoms of GERD in infants include:

• Trouble swallowing
• Refusal to eat
• Chocking
• Hiccups or wet burps
• An infant feeling irritated during or after feeding
• Poor growth and unexplained weight loss
• Sleep disruption
• Recurring pneumonia or cough

If you notice these symptoms often, make an appointment with their doctor.